A POSSIBLE NEW REFLEX PATHWAY FOR MICTURITION AFTER SPINAL-CORD INJURY
A POSSIBLE NEW REFLEX PATHWAY FOR MICTURITION AFTER SPINAL-CORD INJURY
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DOI：
10.1038/sc.1994.52
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发表时间：
1994-05-01
期刊：
影响因子：
--
通讯作者：
GODEC, CJ
中科院分区：
文献类型：
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作者：
XIAO, CG;GODEC, CJ
为了恢复脊髓损伤后的膀胱功能，在大鼠体内建立了一条可控的新反射通路。它涉及一个带有人工修饰的传出分支的躯体反射弧，该分支将躯体运动冲动传递到膀胱。这是通过左侧L4腹根与L 6腹根的硬膜内微吻合术实现的，同时保留L4背根完整作为排尿的起始点。“皮肤-中枢神经系统-膀胱”反射通路被设计为通过抓挠皮肤来启动排泄。轴突再生后，24只大鼠中的15只进行了电生理研究。对左侧L4神经的单次刺激（0.3-3 mA，0.02-0.2 ms持续时间）导致从吻合远端的左侧L 6神经记录到诱发电位（0.5-1 mV）。膀胱逼尿肌收缩非常迅速地启动的列车的刺激和膀胱压力迅速增加到类似于控制的水平。用辣根过氧化物酶（HRP）神经示踪法对6只大鼠进行了研究，结果表明，L4躯体运动神经元成功地将躯体运动轴突再生到盆神经中，并重新支配膀胱。电刺激左侧坐骨神经和抓挠L4相关皮肤也可引起膀胱收缩。从皮肤-中枢神经系统-膀胱反射通路中可以导出一个新的概念：躯体反射弧传出神经元的冲动可以传递到自主效应器，从而启动自主效应器的反应。
In order to restore bladder function after spinal cord injury, a controllable new reflex pathway has been established in rats. It involves a somatic reflex arc with an artificially modified efferent branch which passes the somatic motor impulses to the bladder. This is achieved by intradural microanastomosis of the left L4 ventral root to L6 ventral root, while leaving the L4 dorsal root intact as a starter of micturition. The 'skin-CNS-bladder' reflex pathway is designed to initiate voiding by scratching the skin. After axonal regeneration, 15 of the 24 rats with the new pathway underwent electrophysiological study. Single stimuli (0.3-3 mA, 0.02-0.2 ms duration) to the left L4 nerve resulted in evoked potentials (0.5-1 mV) recorded from the left L6 nerve distal to the anastomosis. The bladder detrusor contraction was very quickly initiated by trains of the stimuli and bladder pressures increased rapidly to levels similar to controls. Neural tracing study with horseradish peroxidase (HRP) on six rats with the pathway demonstrated that the somatic motor axons regenerated successfully into the pelvic nerve, and the bladder was reinnervated by the L4 somatic motor neurons. The bladder contraction can also be initiated by electrostimulation of left sciatic nerve as well as scratching the L4 related skin. A new concept may be derived from the skin-CNS-bladder reflex pathway: the impulses delivered from the efferent neurons of a somatic reflex arc can be transferred to initiate responses of an autonomic effector.